百日咳与百日咳综合征的诊治分析  

Analysis of pertussis and pertussis syndrome

作　　者：闫莉[1] 黄英[1] 叶泽慧[1] 

机构地区：[1]重庆医科大学附属儿童医院呼吸中心儿童发育疾病研究教育部重点实验室儿科学重庆市重点实验室,重庆400014

出　　处：《重庆医科大学学报》2016年第4期355-359,共5页Journal of Chongqing Medical University

摘　　要：目的:分析2014年1月至12月重庆医科大学儿童医院呼吸科住院百日咳及百日咳综合征患儿特点。方法:收集2014年1至12月重庆医科大学附属儿童医院呼吸科收治的256例临床表现疑诊百日咳患儿,经鼻咽分泌物百日咳PCR检测显示阳性者确诊为百日咳共105例(观察组);经鼻咽分泌物百日咳PCR检测显示阴性者诊断为百日咳综合征151例(对照组)。结果:12组患儿性别(χ2=2.167,P=0.141)、年龄构成比(χ2=3.864,P=0.277)相比差异无统计学意义。病程:观察组为15(10,20)d,对照组15(11,21)d(Z=-1.430,P=0.153),差异无统计学意义。2所有患儿均不能提供确切的百日咳接触史,且未接种或未完成3次百日咳疫苗注射。32014年8月为百日咳高发时间,百日咳综合征发病高峰为春季及冬季。42组患儿临床表现差异无统计学意义,血常规、普通病原学及胸部影像学等检查相比有差异,通过百日咳PCR抗原检测可予以确诊。5百日咳可并发肺炎、呼吸衰竭、百日咳脑病等,但总的预后较好。结论:在重庆,百日咳及百日咳综合征发病年龄小,百日咳发病高峰为8月份,经大环内酯类药物及对症等治疗后,总的治疗效果较好,百日咳疫苗免疫接种、通过实验室早期诊断及治疗百日咳是预防和控制百日咳感染的有效方法。Objective：To investigate the hospitalized children with pertussis and pertussis syndrome in the Children＇s Hospital of Chongqing Medical University from January 2014 to December 2014. Methods：Totally 256 cases of hospitalized patients with respiratory tract infection in Children Hospital of Chongqing from January 2014 to December 2014 were analyzed. Positive samples in nasopharyngeal secretion PCR test were classified into observation group（105 cases）;negative samples in nasopharyngeal secretion PCR test were classified into control group（151 cases）. Results：1There was no significant difference in gender（χ2=2.167,P=0.141）and the constituent ratio of age（χ2=3.864,P =0.277）,diseases course（Z =-1.430,P =0.153） between the two groups. 2 All patients were unable to provide exact pertussis contact history,and were not inoculated or received 3 times pertussis vaccine injection.3Pertussis peaked at August 2014;spring and winter are the high-occurrence seasons for pertussis syndrome. 4There was no statistical significance in clinical manifestations between the two groups. But statistical significances in blood routine,common pathogens and chest radiographic examination were observed between the two groups. Pertussis can be diagnosed by PCR antigen test. 5The complications of pertussis were pneumonia,respiratory failure,pertussis encephalopathy,however the prognosis of pertussis was good.Conclusion：In Chongqing,the onset age of pertussis and pertussis syndrome is young;the pertussis occurs highly at August. The overall prognosis is good after macrolides drug and symptomatic treatment. Pertussis vaccine immunization,early diagnosis and treatment of pertussis are effective prevention and control method.

关 键 词：儿童 百日咳 百日咳综合征 PCR 诊断 治疗 

分 类 号：R516.6[医药卫生—内科学]